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Paudel K, Gupta S, Gautam K, Wickersham JA, Khati A, Azwa I, Ha T, Shrestha R. High Interest in Long-acting Injectable Pre-exposure Prophylaxis (LAI-PrEP) for HIV Prevention Among Men Who Have Sex With Men (MSM): Result From A Nationwide Survey in Malaysia. J Community Health 2023; 48:513-521. [PMID: 36732459 PMCID: PMC10200758 DOI: 10.1007/s10900-023-01195-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2023] [Indexed: 02/04/2023]
Abstract
The recent approval of long-acting injectable cabotegravir (CAB-LA) as PrEP for HIV prevention could be an attractive alternative for MSM, particularly among those who face barriers to adherence using the oral pill. This study reports on the awareness of long-acting injectable PrEP (LAI-PrEP) and factors associated with interest in LAI-PrEP use among a nationwide sample of MSM in Malaysia. An online cross-sectional survey was conducted between August and September 2021 to explore perspectives on PrEP modalities among Malaysian MSM (N = 870). Convenience sampling was used to recruit participants using ads on two platforms hornet and facebook. While only 9.1% of the study participants were aware of LAI-PrEP, the majority had heard of oral PrEP (80.9%). After giving a description of it, a large majority (86.6%) expressed interest in using it if made accessible. Those who had a prior history of HIV testing (aOR = 1.9; 95% CI = 1.2-3.2) were more likely to use LAI-PrEP. Interestingly, despite the concerns related to potential high cost (aOR = 3.4; 95% CI = 2.1-5.5) and long-term side effects (aOR = 1.9; 95% CI = 1.2-3.1), the majority of the participants were interested in using LAI-PrEP. Those who were afraid of (or disliked) syringes were less interested in using it (aOR = 0.2; 95% CI; 0.1-0.4). In the recent context that LAI-PrEP was shown to be safe and effective at preventing HIV, our results indicate its potential relevance as an additional PrEP option that could accelerate the uptake and scale-up of PrEP. However, it is crucial to conduct future research urgently to improve the understanding of strategies that could enhance the accessibility, acceptability, and affordability of LAI-PrEP for MSM in low- and middle-income countries, including Malaysia.
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Affiliation(s)
- Kiran Paudel
- Nepal Health Frontiers, Tokha-5, Kathmandu, Nepal
- Department of Allied Health Sciences, University of Connecticut, 06269, Storrs, CT, USA
| | - Sana Gupta
- Department of Allied Health Sciences, University of Connecticut, 06269, Storrs, CT, USA
| | - Kamal Gautam
- Department of Allied Health Sciences, University of Connecticut, 06269, Storrs, CT, USA
| | - Jeffrey A Wickersham
- Yale School of Medicine, Department of Internal Medicine, Section of Infectious Diseases, 135 College St., Suite 323, 06510, New Haven, CT, USA
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Antoine Khati
- Department of Allied Health Sciences, University of Connecticut, 06269, Storrs, CT, USA
| | - Iskandar Azwa
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Infectious Diseases Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Toan Ha
- Department of Infectious Diseases and Microbiology, School of Public Health, University of Pittsburgh, 15261, Pittsburgh, PA, USA
| | - Roman Shrestha
- Department of Allied Health Sciences, University of Connecticut, 06269, Storrs, CT, USA.
- Yale School of Medicine, Department of Internal Medicine, Section of Infectious Diseases, 135 College St., Suite 323, 06510, New Haven, CT, USA.
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
- , 358 Mansfield Road, 1101, 06260-1101, Unit, Storrs, CT, USA.
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Sievwright KM, Stangl AL, Nyblade L, Lippman SA, Logie CH, Veras MADSM, Zamudio-Haas S, Poteat T, Rao D, Pachankis JE, Kumi Smith M, Weiser SD, Brooks RA, Sevelius JM. An Expanded Definition of Intersectional Stigma for Public Health Research and Praxis. Am J Public Health 2022; 112:S356-S361. [PMID: 35763723 PMCID: PMC9241457 DOI: 10.2105/ajph.2022.306718] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2022] [Indexed: 11/04/2022]
Affiliation(s)
- Kirsty M Sievwright
- Kirsty M. Sievwright and Anne Stangl are with the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Laura Nyblade is with the Global Health Division, International Development Group, RTI International, Washington, DC. Sheri A. Lippman, Sophia Zamudio-Haas, Sheri Weiser, and Jae M. Sevelius are with the Department of Medicine, University of California, San Francisco. Carmen H. Logie is with the Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada. Maria Amélia Veras is with the Collective Health, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil. Tonia Poteat is with the Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill. Deepa Rao is with the Department of Global Health, University of Washington, Seattle. John E. Pachankis is with the Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT. M. Kumi Smith is with the Department of Epidemiology & Community Health, University of Minnesota Twin Cities, Minneapolis. Ronald Brooks is with the Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Anne L Stangl
- Kirsty M. Sievwright and Anne Stangl are with the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Laura Nyblade is with the Global Health Division, International Development Group, RTI International, Washington, DC. Sheri A. Lippman, Sophia Zamudio-Haas, Sheri Weiser, and Jae M. Sevelius are with the Department of Medicine, University of California, San Francisco. Carmen H. Logie is with the Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada. Maria Amélia Veras is with the Collective Health, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil. Tonia Poteat is with the Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill. Deepa Rao is with the Department of Global Health, University of Washington, Seattle. John E. Pachankis is with the Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT. M. Kumi Smith is with the Department of Epidemiology & Community Health, University of Minnesota Twin Cities, Minneapolis. Ronald Brooks is with the Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Laura Nyblade
- Kirsty M. Sievwright and Anne Stangl are with the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Laura Nyblade is with the Global Health Division, International Development Group, RTI International, Washington, DC. Sheri A. Lippman, Sophia Zamudio-Haas, Sheri Weiser, and Jae M. Sevelius are with the Department of Medicine, University of California, San Francisco. Carmen H. Logie is with the Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada. Maria Amélia Veras is with the Collective Health, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil. Tonia Poteat is with the Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill. Deepa Rao is with the Department of Global Health, University of Washington, Seattle. John E. Pachankis is with the Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT. M. Kumi Smith is with the Department of Epidemiology & Community Health, University of Minnesota Twin Cities, Minneapolis. Ronald Brooks is with the Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Sheri A Lippman
- Kirsty M. Sievwright and Anne Stangl are with the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Laura Nyblade is with the Global Health Division, International Development Group, RTI International, Washington, DC. Sheri A. Lippman, Sophia Zamudio-Haas, Sheri Weiser, and Jae M. Sevelius are with the Department of Medicine, University of California, San Francisco. Carmen H. Logie is with the Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada. Maria Amélia Veras is with the Collective Health, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil. Tonia Poteat is with the Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill. Deepa Rao is with the Department of Global Health, University of Washington, Seattle. John E. Pachankis is with the Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT. M. Kumi Smith is with the Department of Epidemiology & Community Health, University of Minnesota Twin Cities, Minneapolis. Ronald Brooks is with the Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Carmen H Logie
- Kirsty M. Sievwright and Anne Stangl are with the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Laura Nyblade is with the Global Health Division, International Development Group, RTI International, Washington, DC. Sheri A. Lippman, Sophia Zamudio-Haas, Sheri Weiser, and Jae M. Sevelius are with the Department of Medicine, University of California, San Francisco. Carmen H. Logie is with the Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada. Maria Amélia Veras is with the Collective Health, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil. Tonia Poteat is with the Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill. Deepa Rao is with the Department of Global Health, University of Washington, Seattle. John E. Pachankis is with the Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT. M. Kumi Smith is with the Department of Epidemiology & Community Health, University of Minnesota Twin Cities, Minneapolis. Ronald Brooks is with the Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Maria Amélia de Sousa Mascena Veras
- Kirsty M. Sievwright and Anne Stangl are with the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Laura Nyblade is with the Global Health Division, International Development Group, RTI International, Washington, DC. Sheri A. Lippman, Sophia Zamudio-Haas, Sheri Weiser, and Jae M. Sevelius are with the Department of Medicine, University of California, San Francisco. Carmen H. Logie is with the Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada. Maria Amélia Veras is with the Collective Health, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil. Tonia Poteat is with the Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill. Deepa Rao is with the Department of Global Health, University of Washington, Seattle. John E. Pachankis is with the Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT. M. Kumi Smith is with the Department of Epidemiology & Community Health, University of Minnesota Twin Cities, Minneapolis. Ronald Brooks is with the Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Sophia Zamudio-Haas
- Kirsty M. Sievwright and Anne Stangl are with the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Laura Nyblade is with the Global Health Division, International Development Group, RTI International, Washington, DC. Sheri A. Lippman, Sophia Zamudio-Haas, Sheri Weiser, and Jae M. Sevelius are with the Department of Medicine, University of California, San Francisco. Carmen H. Logie is with the Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada. Maria Amélia Veras is with the Collective Health, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil. Tonia Poteat is with the Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill. Deepa Rao is with the Department of Global Health, University of Washington, Seattle. John E. Pachankis is with the Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT. M. Kumi Smith is with the Department of Epidemiology & Community Health, University of Minnesota Twin Cities, Minneapolis. Ronald Brooks is with the Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Tonia Poteat
- Kirsty M. Sievwright and Anne Stangl are with the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Laura Nyblade is with the Global Health Division, International Development Group, RTI International, Washington, DC. Sheri A. Lippman, Sophia Zamudio-Haas, Sheri Weiser, and Jae M. Sevelius are with the Department of Medicine, University of California, San Francisco. Carmen H. Logie is with the Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada. Maria Amélia Veras is with the Collective Health, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil. Tonia Poteat is with the Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill. Deepa Rao is with the Department of Global Health, University of Washington, Seattle. John E. Pachankis is with the Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT. M. Kumi Smith is with the Department of Epidemiology & Community Health, University of Minnesota Twin Cities, Minneapolis. Ronald Brooks is with the Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Deepa Rao
- Kirsty M. Sievwright and Anne Stangl are with the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Laura Nyblade is with the Global Health Division, International Development Group, RTI International, Washington, DC. Sheri A. Lippman, Sophia Zamudio-Haas, Sheri Weiser, and Jae M. Sevelius are with the Department of Medicine, University of California, San Francisco. Carmen H. Logie is with the Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada. Maria Amélia Veras is with the Collective Health, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil. Tonia Poteat is with the Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill. Deepa Rao is with the Department of Global Health, University of Washington, Seattle. John E. Pachankis is with the Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT. M. Kumi Smith is with the Department of Epidemiology & Community Health, University of Minnesota Twin Cities, Minneapolis. Ronald Brooks is with the Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - John E Pachankis
- Kirsty M. Sievwright and Anne Stangl are with the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Laura Nyblade is with the Global Health Division, International Development Group, RTI International, Washington, DC. Sheri A. Lippman, Sophia Zamudio-Haas, Sheri Weiser, and Jae M. Sevelius are with the Department of Medicine, University of California, San Francisco. Carmen H. Logie is with the Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada. Maria Amélia Veras is with the Collective Health, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil. Tonia Poteat is with the Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill. Deepa Rao is with the Department of Global Health, University of Washington, Seattle. John E. Pachankis is with the Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT. M. Kumi Smith is with the Department of Epidemiology & Community Health, University of Minnesota Twin Cities, Minneapolis. Ronald Brooks is with the Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - M Kumi Smith
- Kirsty M. Sievwright and Anne Stangl are with the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Laura Nyblade is with the Global Health Division, International Development Group, RTI International, Washington, DC. Sheri A. Lippman, Sophia Zamudio-Haas, Sheri Weiser, and Jae M. Sevelius are with the Department of Medicine, University of California, San Francisco. Carmen H. Logie is with the Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada. Maria Amélia Veras is with the Collective Health, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil. Tonia Poteat is with the Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill. Deepa Rao is with the Department of Global Health, University of Washington, Seattle. John E. Pachankis is with the Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT. M. Kumi Smith is with the Department of Epidemiology & Community Health, University of Minnesota Twin Cities, Minneapolis. Ronald Brooks is with the Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Sheri D Weiser
- Kirsty M. Sievwright and Anne Stangl are with the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Laura Nyblade is with the Global Health Division, International Development Group, RTI International, Washington, DC. Sheri A. Lippman, Sophia Zamudio-Haas, Sheri Weiser, and Jae M. Sevelius are with the Department of Medicine, University of California, San Francisco. Carmen H. Logie is with the Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada. Maria Amélia Veras is with the Collective Health, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil. Tonia Poteat is with the Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill. Deepa Rao is with the Department of Global Health, University of Washington, Seattle. John E. Pachankis is with the Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT. M. Kumi Smith is with the Department of Epidemiology & Community Health, University of Minnesota Twin Cities, Minneapolis. Ronald Brooks is with the Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Ronald A Brooks
- Kirsty M. Sievwright and Anne Stangl are with the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Laura Nyblade is with the Global Health Division, International Development Group, RTI International, Washington, DC. Sheri A. Lippman, Sophia Zamudio-Haas, Sheri Weiser, and Jae M. Sevelius are with the Department of Medicine, University of California, San Francisco. Carmen H. Logie is with the Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada. Maria Amélia Veras is with the Collective Health, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil. Tonia Poteat is with the Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill. Deepa Rao is with the Department of Global Health, University of Washington, Seattle. John E. Pachankis is with the Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT. M. Kumi Smith is with the Department of Epidemiology & Community Health, University of Minnesota Twin Cities, Minneapolis. Ronald Brooks is with the Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles
| | - Jae M Sevelius
- Kirsty M. Sievwright and Anne Stangl are with the Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. Laura Nyblade is with the Global Health Division, International Development Group, RTI International, Washington, DC. Sheri A. Lippman, Sophia Zamudio-Haas, Sheri Weiser, and Jae M. Sevelius are with the Department of Medicine, University of California, San Francisco. Carmen H. Logie is with the Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada. Maria Amélia Veras is with the Collective Health, Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, Brazil. Tonia Poteat is with the Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill. Deepa Rao is with the Department of Global Health, University of Washington, Seattle. John E. Pachankis is with the Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT. M. Kumi Smith is with the Department of Epidemiology & Community Health, University of Minnesota Twin Cities, Minneapolis. Ronald Brooks is with the Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles
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Ayala G, Sprague L, van der Merwe LLA, Thomas RM, Chang J, Arreola S, Davis SLM, Taslim A, Mienies K, Nilo A, Mworeko L, Hikuam F, de Leon Moreno CG, Izazola-Licea JA. Peer- and community-led responses to HIV: A scoping review. PLoS One 2021; 16:e0260555. [PMID: 34852001 PMCID: PMC8635382 DOI: 10.1371/journal.pone.0260555] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/18/2021] [Indexed: 01/18/2023] Open
Abstract
INTRODUCTION In June 2021, United Nations (UN) Member States committed to ambitious targets for scaling up community-led responses by 2025 toward meeting the goals of ending the AIDS epidemic by 2030. These targets build on UN Member States 2016 commitments to ensure that 30% of HIV testing and treatment programmes are community-led by 2030. At its current pace, the world is not likely to meet these nor other global HIV targets, as evidenced by current epidemiologic trends. The COVID-19 pandemic threatens to further slow momentum made to date. The purpose of this paper is to review available evidence on the comparative advantages of community-led HIV responses that can better inform policy making towards getting the world back on track. METHODS We conducted a scoping review to gather available evidence on peer- and community-led HIV responses. Using UNAIDS' definition of 'community-led' and following PRISMA guidelines, we searched peer-reviewed literature published from January 1982 through September 2020. We limited our search to articles reporting findings from randomized controlled trials as well as from quasi-experimental, prospective, pre/post-test evaluation, and cross-sectional study designs. The overall goals of this scoping review were to gather available evidence on community-led responses and their impact on HIV outcomes, and to identify key concepts that can be used to quickly inform policy, practice, and research. FINDINGS Our initial search yielded 279 records. After screening for relevance and conducting cross-validation, 48 articles were selected. Most studies took place in the global south (n = 27) and a third (n = 17) involved youth. Sixty-five percent of articles (n = 31) described the comparative advantage of peer- and community-led direct services, e.g., prevention and education (n = 23) testing, care, and treatment programs (n = 8). We identified more than 40 beneficial outcomes linked to a range of peer- and community-led HIV activities. They include improved HIV-related knowledge, attitudes, intentions, self-efficacy, risk behaviours, risk appraisals, health literacy, adherence, and viral suppression. Ten studies reported improvements in HIV service access, quality, linkage, utilization, and retention resulting from peer- or community-led programs or initiatives. Three studies reported structural level changes, including positive influences on clinic wait times, treatment stockouts, service coverage, and exclusionary practices. CONCLUSIONS AND RECOMMENDATIONS Findings from our scoping review underscore the comparative advantage of peer- and community-led HIV responses. Specifically, the evidence from the published literature leads us to recommend, where possible, that prevention programs, especially those intended for people living with and disproportionately affected by HIV, be peer- and community-led. In addition, treatment services should strive to integrate specific peer- and community-led components informed by differentiated care models. Future research is needed and should focus on generating additional quantitative evidence on cost effectiveness and on the synergistic effects of bundling two or more peer- and community-led interventions.
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Affiliation(s)
- George Ayala
- MPact Global Action for Gay Men’s Health and Rights, Oakland, CA, United States of America
- Alameda County Department of Public Health, Oakland, CA, United States of America
- * E-mail:
| | - Laurel Sprague
- Joint United Nations Programme on HIV/AIDS (UNAIDS), Geneva, Switzerland
| | - L. Leigh-Ann van der Merwe
- Social, Health and Empowerment Feminist Collective of Transgender Women in Africa, East London, South Africa
- Innovative Response Globally to Transgender Women and HIV (IRGT), Oakland, CA, United States of America
| | | | - Judy Chang
- International Network of People Who Use Drugs, London, United Kingdom
| | - Sonya Arreola
- MPact Global Action for Gay Men’s Health and Rights, Oakland, CA, United States of America
- Arreola Research, San Francisco, CA, United States of America
| | | | | | - Keith Mienies
- The Global Fund to Fight AIDS, Tuberculosis, and Malaria, Geneva, Switzerland
| | | | - Lillian Mworeko
- International Community of Women Living with HIV Eastern Africa, Kampala, Uganda
| | - Felicita Hikuam
- AIDS and Rights Alliance for Southern Africa, Windhoek, Namibia
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